What is psoriatic arthritis? Its causes, triggers and risk factors

Psoriatic arthritis can affect any joint, but is most common in the joints of the fingers, toes, lower back, wrists, knees, or ankles. Both psoriasis and PsA cause episodes where the symptoms worsen, also known as flares. Most of the time, the symptoms will lessen between flares

According to the American College of Rheumatology, around 15 percent of people with psoriasis will develop a type of inflammatory arthritis, known as psoriatic arthritis (PsA). It’s possible, however, for someone without the skin changes of psoriasis to develop PsA, especially if someone else in their family has the disease.

Understanding what triggers PsA flares is essential to helping prevent them. Keeping a journal and recording information about what has happened before a PsA flare may help.

A person with PsA should keep an eye out specifically for these common triggers, or other factors that might be causing the symptoms. There are online trackers and apps available, but even just a simple pen and paper journal may be useful.

Sharing this information with a doctor can help identify effective treatments or simple lifestyle changes that could improve symptoms.

Risk factors

There are several risk factors that have been associated with developing PsA:

Age: People between the ages of 30-50 are most likely to develop PsA. It is possible, however, for people of any age to get the disease.

Family history: People with a family history of psoriasis or PsA are more likely to get the disease, than those without.

Medical history: Having psoriasis is the biggest risk factor for getting PsA. In most cases, people develop PsA after they already have the rash of psoriasis, though it is possible for PsA to develop before any skin lesions appear.

Symptoms

The symptoms of PsA vary from person to person and can range from very mild to severe. They may include:

PsA can affect any joint, but is most common in the joints of the fingers, toes, lower back, wrists, knees, or ankles.

Both psoriasis and PsA cause episodes where the symptoms worsen, also known as flares. Most of the time, the symptoms will lessen between flares.

In most cases, a person with PsA will be diagnosed with psoriasis before developing the joint stiffness and pain associated with arthritis. However, some people will have symptoms of the arthritis before being diagnosed with psoriasis.

Types of PsA

There are five different patterns of PsA that have been identified, based on the number and types of joints involved. They are:

testing for the presence of uric acid crystals in joint fluid if there is concern about gout

Symptoms of PsA can appear and then disappear before someone can get to the doctor, making diagnosis difficult. It’s not uncommon for a person to have a few flares before the disease is diagnosed.

Anyone with a history of psoriasis and joint pain or swelling should see their doctor promptly. They should be sure to mention that they have psoriasis so that they can be properly evaluated.

Treatment options

Pain management is usually a major concern for people with PsA. There are many different options available and it can sometimes take a bit of trial and error before the best option is found.

Mild exercise and staying active can help to relieve painful joints and stiff muscles. Particularly effective exercises for patients with PsA include yoga and swimming. It’s important for people to find an activity that is comfortable and then to stick with it.

There are several different medications that can be used to treat symptoms and prevent joint damage in people with PsA. The doctor will select a medication based on the amount of pain, swelling and stiffness that the patient has.

Options include:

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, which can be very effective for mild cases.